Surgical stapling device with elongated tool assembly and methods of use

ABSTRACT

A surgical stapling device includes an elongated tool assembly having spaced first and second jaws positioned to receive a body organ. The length of the tool assembly (which may have a curved configuration) is selected to receive and staple and/or transect a body organ in a single actuation of the tool assembly.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. application Ser. No. 15/588,822, filed May 8, 2017 now U.S. Pat. No. 10,390,826, the entire disclosure of which is incorporated by reference herein.

BACKGROUND 1. Technical Description

The present disclosure is directed to surgical stapling devices, and more particularly, to surgical stapling devices that include elongated tool assemblies dimensioned to perform transection of body organs in a single actuation of the tool assembly.

2. Background of Related Art

During surgical procedures such as gastric sleeve procedures, i.e., sleeve gastrectomy procedures, a portion of a body organ, e.g., the stomach is divided and/or removed using a surgical stapling device having a knife. Typically, the surgical stapling device includes a tool assembly that has a length that is shorter than the length of the portion of the body organ being transected. As such, the surgical stapling device must be actuated multiple times to provide a staple/cut line that extends entirely across the body organ. To avoid creating a staple line that is susceptible to leakage, the clinician must properly align the stapling device with an existing portion of the staple/cut line during each actuation of the surgical stapling device to form a continuous staple line along the cut line.

It would be desirable to provide a surgical stapling device capable of transecting a body organ such as the stomach more quickly while minimizing the potential for leakage along the staple line.

SUMMARY

In one aspect of the present disclosure, a surgical stapling device includes an actuator including a housing defining a handle assembly, an adaptor assembly having a proximal portion releasably secured to the actuator and a distal portion. A tool assembly is supported on the distal portion of the adaptor assembly and includes a first jaw and a second jaw. The first jaw is movable in relation to the second jaw from an unclamped position to a clamped position. The first jaw is secured to the second jaw by distal and proximal approximation shafts. The distal and proximal approximation shafts are configured to effect parallel closure of the first and second jaws of the tool assembly. In the unclamped position, the distal approximation shaft is secured to a distal portion of the first jaw and a distal portion of the second jaw to secure the distal portion of the first jaw of the tool assembly to the distal portion of the second jaw, and the proximal approximation shaft is secured to a proximal portion of the first jaw and a proximal portion of the second jaw to secure the proximal portion of the first jaw to the proximal portion of the second jaw.

In some embodiments, the first jaw supports an anvil and the second jaw supports a cartridge assembly.

In certain embodiments, the cartridge assembly includes a staple cartridge having a plurality of staples.

In embodiments, the cartridge assembly includes an anvil drive screw that is operably engaged with the distal and proximal approximation shafts and is actuable via the actuator to effect parallel closure of the first and second jaws of the tool assembly.

In some embodiments, the cartridge assembly includes a sled that is supported within the staple cartridge and movable from a retracted position to an advanced position to eject the plurality of staples from the staple cartridge.

In certain embodiments, the cartridge assembly includes a sled drive screw that is operably engaged with the sled to move the sled from the retracted position to the advanced position.

In embodiments, the tool assembly defines a radius of curvature of between 15 cm and 35 cm.

In some embodiments, the tool assembly has a length of between 27 cm and 34 cm.

In certain embodiments, the tool assembly has a length of between 8 cm and 10 cm.

In embodiments, the tool assembly has a length of between 6 cm and 8 cm.

In some embodiments, the proximal approximation shaft includes a pair of proximal approximation shafts and the distal approximation shaft includes a pair of distal approximation shafts.

In certain embodiments, each of the proximal and distal approximation shafts includes a threaded shaft rotatably supported on the first jaw and axially fixed to the first jaw, and the second jaw defines a threaded bore that receives each of the proximal and distal approximation shafts, wherein rotation of the proximal and distal approximation shafts effects movement of the first jaw in relation to the second jaw between the clamped and unclamped positions.

In another aspect of the disclosure a tool assembly includes a first jaw and a second jaw movable in relation to the each other from an unclamped position to a clamped position. The first jaw is secured to the second jaw by distal and proximal approximation shafts. The distal and proximal approximation shafts are configured to effect parallel closure of the first and second jaws of the tool assembly. In the unclamped position, the distal approximation shaft is secured to a distal portion of the first jaw and a distal portion of the second jaw to secure the distal portion of the first jaw of the tool assembly to the distal portion of second jaw of the tool assembly, and the proximal approximation shaft is secured to a proximal portion of the first jaw and a proximal portion of the second jaw to secure the proximal portion of the first jaw to the proximal portion of the second jaw.

In embodiments, the first jaw supports an anvil and the second jaw supports a cartridge assembly.

In some embodiments, the cartridge assembly includes an anvil drive screw that is operably engaged with the distal and proximal approximation shafts and is actuable to effect parallel closure of the jaws of the tool assembly.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the presently disclosed elongate tool assembly in association with a surgical stapling device are described herein below with reference to the drawings, wherein:

FIG. 1 is a side perspective view of one embodiment of the presently disclosed surgical stapling device with the tool assembly in a clamped position;

FIG. 2 is a perspective view of a proximal end of an adaptor assembly of the surgical stapling device shown in FIG. 1 and a distal end of the actuator of the surgical stapling device shown in FIG. 1 with parts separated illustrating an interface between the adaptor assembly and the actuator;

FIG. 6 is an enlarged, side perspective view of the tool assembly of the surgical stapling device shown in FIG. 1 with the tool assembly in the clamped position;

FIG. 3 is an enlarged, side perspective view of the tool assembly of the surgical stapling device shown in FIG. 1 with the tool assembly in the unclamped position;

FIG. 4 is a cross-sectional view taken along the longitudinal axis of the tool assembly shown in FIG. 3 in the unclamped position;

FIG. 5 is a cross-sectional view taken along section line 5-5 of FIG. 4;

FIG. 6 is an enlarged, side perspective view of the tool assembly of the surgical stapling device shown in FIG. 1 with the tool assembly in the clamped position;

FIG. 7 is a cross-sectional view taken along the longitudinal axis of the tool assembly shown in FIG. 6 in the clamped position;

FIG. 8 is a cross-sectional view taken along section line 8-8 of FIG. 7; and

FIG. 9 is a top view of the tool assembly of the surgical stapling device shown in FIG. 1 positioned about a body organ;

DETAILED DESCRIPTION OF EMBODIMENTS

The presently disclosed surgical stapling device including an elongated tool assembly will now be described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. In this description, the term “proximal” is used generally to refer to that portion of the device that is closer to a clinician, while the term “distal” is used generally to refer to that portion of the device that is farther from the clinician. In addition, the term “clinician” is used generally to refer to medical personnel including doctors, nurses, and support personnel. Further, the term “parallel closure” of a tool assembly is used herein generally to refer to approximation of first and second jaws of the tool assembly with planes defined by tissue contact surfaces of the first and second jaws in a substantially parallel orientation, i.e., planes that together define an angle of less than about 10 degrees.

The presently disclosed surgical stapling device includes an actuator, an adaptor assembly extending distally from the actuator, and an elongated tool assembly that includes spaced jaws positioned to receive a body organ between proximal and distal ends of the jaws. In embodiments, the tool assembly has a length of about 6 cm to about 34 cm. The length of the tool assembly is selected to be suitable for a particular surgical procedure. For example, in surgical procedures including gastric sleeve procedures, the tool assembly may have a length of from about 27 cm to about 34 cm. In surgical procedures such as lobectomy procedures, the tool assembly may have a length of about 8 cm to about 10 cm. In addition, for other procedures such as hysterectomy, nephrectomy and colectomy procedures, the tool assembly may have a length of about 6 cm to about 8 cm.

In some embodiments, the tool assembly has a curved configuration, e.g., banana-shaped, although other configurations, including linear, are envisioned. To prevent outward deflection of the jaws of the tool assembly during clamping and firing of the elongated tool assembly, proximal and distal ends of the jaws are secured together with approximation members. The approximation members are positioned to effect parallel closure of the jaws of the tool assembly. By providing a tool assembly that is dimensioned to transect a body organ in a single actuation of the tool assembly, the time required to perform a surgical procedure and the experience level of the clinician required to perform the surgical procedure are lessened.

Referring to FIGS. 1 and 2, the presently disclosed surgical stapling device, shown generally as 10, includes an actuator 12, an adaptor assembly 14 extending distally from the actuator 12, and a tool assembly 16 (FIG. 1) supported on a distal portion of the adaptor assembly 14. The tool assembly 16 may form part of a reload assembly 17 that is releasably coupled to a distal portion of the adaptor assembly 14. Alternately, the tool assembly 16 may be secured directly to the distal portion of the adaptor assembly 14. In embodiments, the stapling device 10 is a powered, handheld electromechanical stapling device and the actuator 12 includes a housing 18 that supports a battery (not shown) and a plurality of actuation buttons 20. The adaptor assembly 14 is releasably coupled to the actuator 12 and includes a plurality of driven shafts 22 (FIG. 2) that communicate with drive shafts 24 of the actuator 12 to actuate various functions of the tool assembly 16 including approximation, articulation, and firing. The actuation buttons 20 are operable to actuate the tool assembly 16. U.S. Patent Publication No. 2015/0157321 discloses an electromechanical surgical stapling device including an actuator and adaptor assembly suitable for use with the presently disclosed stapling device and is incorporated herein by reference in its entirety. Alternately, it is envisioned that the tool assembly 16 of the stapling device 10 may be incorporated into a manually powered stapling device or, in the alternative, be configured to be used in association with a robotically driven system.

Referring to FIGS. 3-5, the tool assembly 16 includes first and second jaws 30, 32. In embodiments, the first and second jaws 30, 32 are curved along their lengths and define a banana-like shape. In some embodiments, the first and second jaws 30, 32 have a radius of curvature of from about 15 cm to about 35 cm. However, it is envisioned that the size and curvature of the tool assembly 16 be selected to be suitable for a particular surgical procedure as discussed in further detail below. The first jaw 30 is supported in relation to the second jaw 32 for movement between an unclamped position (FIG. 3) and a clamped position (FIG. 6). In embodiments, the first jaw 30 is supported in relation to the second jaw 32 for parallel closure.

In embodiments, the first jaw 30 supports an anvil 34 that defines a first tissue contacting surface 36 and the second jaw 32 supports a cartridge assembly 38 that defines a second tissue contacting surface 40. The cartridge assembly 38 includes a staple cartridge 42 that defines a plurality of staple retention slots 44 and a flexible staple drive member 46 (FIG. 4) that supports an actuation sled 48 and a knife bar 50 that is secured to the actuation sled 48. The staple drive member 46 is engaged with one of the driven shafts 22 (FIG. 2) of the actuator 12 such that actuation of the staple drive member 46 effects translation of the actuation sled 48 and knife bar 50 through the tool assembly 16. In embodiments, the staple drive member 46 includes a threaded drive shaft 46 a and the actuation sled 48 defines a threaded bore 48 a (FIG. 4) that receives the threaded drive shaft 46 a such that rotation of the threaded drive shaft 46 a effects translation of the actuation sled 48 and knife bar 50 through the tool assembly 16. The threaded drive shaft 46 a is supported between distal and proximal bearing members 54, 56. Each of the staple retention slots 44 receives a staple (not shown) and a pusher (not shown) as is known in the art. The actuation sled 48 and the knife bar 50 are movable through the tool assembly 16 to sequentially eject the staples (not shown) from the staple retention slots 44 of the staple cartridge 42 and transect tissue.

The cartridge assembly 38 also includes a flexible jaw drive member 60 (FIG. 4) and spaced distal and proximal approximation shafts 62 a and 62 b, respectively. The jaw drive member 60 is positioned to engage the approximation shafts 62 a and 62 b and has a distal portion supported on the distal bearing member 54 and a proximal portion supported on the proximal bearing member 56. The distal and proximal approximation shafts 62 a and 62 b are supported in orthogonal relation to the jaw drive member 60 at each end of the tool assembly 16. In embodiments, the cartridge assembly 38 includes two distal and two proximal threaded approximation shafts 62 a and 62 b (FIGS. 5 and 8). Alternately, the use of a single distal and proximal approximation shaft 62 a is envisioned. Each of the approximation shafts 62 a and 62 b has a first end that is rotatably supported but axially fixed in relation to one of the jaws, and a second end that is received within a threaded bore 66 (FIG. 5) of the other jaw. For example, the approximation shafts 62 a and 62 b may have a first end rotatably supported but axially fixed to the first jaw 30 and a second end that is received in a threaded bore 66 (FIG. 5) of the second jaw 32. Alternately, the second jaw 32 may support the approximation shafts 62 a and 62 b and the first jaw 30 may include the threaded bore 66.

Referring to FIGS. 6-8, when the jaw drive member 60 is actuated, the approximation shafts 62 a and 62 b are rotated to move the first jaw 30 in relation to the second jaw 32 to move the tissue contacting surfaces 36 and 40 of the first and second jaws 30 and 32, respectively, in relation to each other between spaced (FIGS. 4 and 5) and approximated (FIGS. 7 and 8) positions. When this occurs, tissue positioned between the jaws 30, 32 is clamped between the jaws 30, 32. Once the tissue is properly clamped between the jaws 30, 32, the staple drive member 46 can be actuated via the actuator 12 to advance the actuation sled 48 and knife bar 50 through the tool assembly 16 to staple and transect tissue clamped between the jaws 30, 32.

Referring also to FIG. 9, during a surgical procedure, such as a gastric sleeve procedure, a surgical stapling device 10 (FIG. 1) having an appropriately sized tool assembly 16 is positioned adjacent to a body organ, e.g., the stomach “S”. With the tool assembly 16 in the unclamped position (FIG. 3), a portion of the stomach “S” is pulled with a grasper or the like (not shown) to a position between the jaws 30, 32 of the tool assembly 16. When the stomach “S” is properly positioned within the tool assembly 16 to apply an appropriate staple line to the stomach “S”, the jaw drive member 60 (FIG. 7) is actuated to move the jaws 30, 32 in the direction indicated by arrow “A” in FIG. 8 from the unclamped position (FIG. 3) to the clamped position (FIG. 6) to clamp the stomach “S”. Thereafter, the staple drive member 46 is actuated to advance the actuation sled 48 through the tool assembly 16 to staple and dissect tissue. It is noted that the actuation sled 48 may support the knife bar 50. Alternately, the tool assembly 16 need not have a knife bar 50 such that advancement of the actuation sled 48 only applies staples to a body organ to create a pouch within the body organ such as the stomach “S”.

Persons skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments. It is envisioned that the elements and features illustrated or described in connection with one exemplary embodiment may be combined with the elements and features of another without departing from the scope of the present disclosure. As well, one skilled in the art will appreciate further features and advantages of the disclosure based on the above-described embodiments. Accordingly, the disclosure is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. 

What is claimed is:
 1. A surgical stapling device comprising: an adaptor assembly having a proximal portion and a distal portion; and a tool assembly supported on the distal portion of the adaptor assembly, the tool assembly including a first jaw and a second jaw supported in parallel alignment with the first jaw, the first and second jaws each having a distal portion and a proximal portion, a distal approximation shaft positioned between the distal portions of the first and second jaws, and a proximal approximation shaft positioned between the proximal portions of the first and second jaws, wherein, the first jaw is movable in relation to the second jaw from an unclamped position to a clamped position.
 2. The surgical stapling device of claim 1, wherein the first jaw supports an anvil and the second jaw supports a cartridge assembly.
 3. The surgical stapling device of claim 2, wherein the cartridge assembly includes a staple cartridge having a plurality of staples.
 4. The surgical stapling device of claim 3, wherein the cartridge assembly includes an anvil drive screw, the anvil drive screw being operably engaged with the distal and proximal approximation shafts and actuable to effect parallel closure of the jaws of the tool assembly.
 5. The surgical stapling device of claim 4, wherein the cartridge assembly includes a sled that is supported within the staple cartridge and movable from a retracted position to an advanced position to eject the plurality of staples from the staple cartridge.
 6. The surgical stapling device of claim 5, wherein the cartridge assembly includes a sled drive screw, the sled drive screw being operably engaged with the sled to move the sled from the retracted position to the advanced position.
 7. The surgical stapling device of claim 1, wherein the tool assembly defines a radius of curvature of between 15 cm and 35 cm.
 8. The surgical stapling device of claim 7, wherein the tool assembly has a length of between 27 cm and 34 cm.
 9. The surgical stapling device of claim 7, wherein the tool assembly has a length of between 8 cm and 10 cm.
 10. The surgical stapling device of claim 7, wherein the tool assembly has a length of between 6 cm and 8 cm.
 11. The surgical stapling device of claim 1, wherein the proximal approximation shaft includes a pair of proximal approximation shafts and the distal approximation shaft includes a pair of distal approximation shafts.
 12. The surgical stapling device of claim 1, wherein each of the proximal and distal approximation shafts includes a threaded shaft that is rotatably supported on the first jaw, the second jaw defining threaded bores that receive each of the proximal and distal approximation shafts, wherein rotation of the proximal and distal approximation shafts effects movement of the first jaw in relation to the second jaw between the clamped and unclamped positions.
 13. The surgical stapling device of claim 1, wherein the distal and proximal approximation shafts are configured to effect parallel closure of the first and second jaws of the tool assembly.
 14. A tool assembly comprising: a first jaw and a second jaw supported in parallel alignment with the first jaw, the first jaw and second jaw each having a distal portion and a proximal portion, a distal approximation shaft positioned between the distal portions of the first and second jaws, and a proximal approximation shaft positioned between the proximal portions of the first and second jaws, wherein the first jaw is movable in relation to the second jaw from an unclamped position to a clamped position.
 15. The tool assembly of claim 14, wherein the first jaw supports an anvil and the second jaw supports a cartridge assembly.
 16. The tool assembly of claim 15, wherein the cartridge assembly includes an anvil drive screw, the anvil drive screw operably engaged with the distal and proximal approximation shafts and actuable to effect parallel closure of the first and second jaws of the tool assembly.
 17. The tool assembly of claim 14, wherein the tool assembly has a length of between 27 cm and 34 cm.
 18. The tool assembly of claim 14, wherein the tool assembly has a length of between 6 cm and 10 cm.
 19. The tool assembly of claim 14, wherein the tool assembly defines a radius of curvature of between 15 cm and 35 cm.
 20. The tool assembly of claim 14, wherein each of the proximal and distal approximation shafts includes a threaded shaft that is rotatably supported on the first jaw, the second jaw defining threaded bores that receive each of the proximal and distal approximation shafts, wherein rotation of the proximal and distal approximation shafts effects movement of the first jaw in relation to the second jaw between the clamped and unclamped positions. 